Victoria Means (31 - she/her) and Amos Jude (18 mo)
Houston, TX
How has parenthood impacted your body image?
I am grateful for my body and how pregnancy changed it. Amos was diagnosed with a saccroccocygeal teratoma (SCT), a tumor located at the base of the tailbone, at 20 weeks gestation. Diagnostic testing and consultations were scheduled for the following Wednesday, Valentine’s Day. After a targeted ultrasound, a MRI and a fetal echocardiogram, my husband and I learned Amos had a type II teratoma, meaning it was primarily cystic and external. Due to the size of the teratoma, we were told open fetal surgery might be necessary if complications arose before Amos could survive outside of the womb. Otherwise, the prognosis of pediatric surgery after birth to remove the tumor was hopeful.
The goal of my pregnancy was clear: to carry Amos for as long as possible and deliver via planned cesarean no later than 37 weeks gestation. My pregnancy was managed on a weekly basis by the maternal-fetal medicine team from Baylor OB/GYN at Texas Children’s Pavilion for Women. Since fetal surgery was a possibility, four doctors specializing in fetal intervention oversaw our primary care. We would check in on Amos every three or four days.
One of the primary complications of a SCT is fetal hydrops, an accumulation of excess fluid, which can quickly lead to heart failure if not caught early. Our bi-weekly ultrasounds meticulously monitored tumor growth, key blood flow patterns in Amos’s heart, brain and umbilical cord, and my amniotic fluid level. Frequent fetal echocardiograms accompanied the ultrasounds to further ensure no signs of hydrops were developing. The weeks leading up to when early delivery would trump fetal intervention were harrowing. My husband and I yearned for black-and-white answers, but nobody could tell us what was going to happen with certainty.
My body’s physical changes during this time were completely eclipsed by the intense monitoring protocol. I didn't have the mental capacity to consider how I looked or how I felt about how I looked. Instead, I struggled with simultaneously loving my body and the baby it was nurturing and protecting while hating the tumor that was also growing inside of me. Body image wasn't even on my radar…
In addition to my Cesarean scar, I acquired three other abdominal scars while pregnant. The day after reaching 28 weeks gestation, I was admitted to the hospital for increased amniotic fluid. The tumor caused an overproduction of amniotic fluid (polyhydramnios), which had reached a volume that threatened preterm contractions. In attempts to avoid preterm labor, a needle guided by ultrasound was inserted into my uterus and amniotic fluid was drained until the remaining volume was at an acceptable level. Two weeks later, I was back for another amnioreduction. I thought it’d be wonderful if the procedure bought us another two weeks. However, a week later, I was back for a third amnioreduction.
Amos was born the following morning at 31 weeks gestation. Each time, the insertion of the needle left a small, barely noticeable scar at the puncture site. I love that collectively these scars represent the three weeks of precious time the reductions bought us and what that time meant for Amos's development and health.
What was your postpartum experience?
I didn’t grow up wanting to be a parent. | I was in my mid-20s and had been with my husband for more than 7 years before I began contemplating parenthood. It was another three years before I assumed the responsibility of attempting to create another life. Those three years were spent educating myself on fertility, nutrition, preconception health, conscious conception, the modern medical/maternity care system, navigating the health insurance system, the various costs association with pregnancy/birth/childcare, my choices for maternity care providers and locations, prenatal and newborn care choices and decisions, labor options, postpartum recovery and support, maternity leave…you name the topic and I probably had either read a book, scoured the internet, watched a TED talk, listened to a podcast, or had a conversation with someone (and took copious notes) about it.
I knew there were no guarantees that I would conceive but I didn’t take the possibility of motherhood lightly. I wanted to be well informed and empowered with realistic expectations. But as having Amos has proven, there is no certainty and being informed doesn’t mean you’re in control. I don’t regret learning all that I did; it made me a better advocate for myself and for Amos. However, after receiving the diagnosis, the type of information I had been soaking up for three years suddenly changed. Instead of curating a nursery, creating a baby registry, or planning a baby shower, I was signing up for a “Preparing for your Newborn's Hospitalization” class at Texas Children’s, touring the NICU, learning new medical terms like “cardiomegaly” and “hydronephrosis” and watching (and reviewing) the more than 22 ultrasound reports as they posted to my medical portal.
I had been thrust into a whole new world, one I quickly had to learn how to operate in. The prenatal diagnosis set in motion a series of traumas that I continue to realize, acknowledge, work through, and heal from. I had hoped for a low intervention hospital birth with midwives prior to receiving the diagnosis. I became a high-risk pregnancy and was transferred to a maternal-fetal medicine practice for the remainder of my prenatal care.
He was 4 days old when the tumor was surgically removed. I held Amos briefly after he was born; we reunited later that day in the level IV NICU. He had been wrapped in a blanket then, but he was completely uncovered in the incubator. Seeing the tumor wasn’t as difficult as I had anticipated. While I hated its presence and connection to my son, I was even more in awe of Amos. He survived for almost seven months with that horrible mass; it weighed approximately 2 pounds, making Amos almost 4 pounds at birth. Post operatively, Amos began receiving breast milk and gaining weight, battled and beat a PICC line infection, learned to regulate his body temperature and slowly went from needing a breathing tub to a CPAP machine to a nasal cannula to breathing room air.
My husband and I visited him every day; we would sing to him, stand by his incubator and place our hands on his chest and head for comfort. We would talk to him and eventually hold and feed him. Three weeks after the surgery, pathology from the teratoma returned and revealed a less than 1% composition of malignant cells, meaning the tumor wasn’t completely benign. Thankfully, imaging showed no signs of metastasis. As a precaution, Amos is followed by an oncologist; his lab results and imaging continue to show no sign of reoccurring teratoma!
Amos spent 51 days in the NICU before coming home. The last 11 weeks of my pregnancy were anxiety-filled and while the rigorous monitoring of my high-risk pregnancy concluded with Amos’s birth, the 7 week NICU stay that followed did not allow me to attempt any sort of healing. While Amos progressively healed and grew, time dragged on. It seemed to me as if we’d never go home. I struggled with wanting my baby home with us but knowing he wasn’t ready yet. Amos eventually graduated to the level II NICU, at which time he was still having apnea and bradycardia episodes, which caused him to stop breathing momentarily as his heart rate dropped. The nurses and doctors told us this was normal for a preemie and that Amos would eventually grow out of it. Finally, Amos stopped having episodes and discharge plans were made! Amos came home the day before Father’s Day, weighing 5 pounds and 12 ounces.
I spent 5 weeks at home with Amos before needing to return to work. By the time Amos came home, I was struggling to find the emotional and psychological stamina to care for my preemie and myself. My anxiety was at an unprecedented level. I felt lost in a sea of intense feelings of guilt, anger, and fear; I felt unconfident, relationally disconnected, depressed, and emotionally overwhelmed. It wasn't until I stopped exclusively pumping that I was able to begin processing my trauma.
I exclusively pumped breast milk for 7 months. It happened unintentionally. I had planned to give Amos breastmilk and had prepared to pump during the time he was unable to nurse. We worked to develop our nursing relationship while I attempted to coordinate my pumping every 3-4 hours with my 25 mile drive to and from the NICU each day, my being present for rounds with the attending physicians in order to be involved and informed in Amos's care as well as to advocate for him, and my meeting my basic needs like eating and sleeping. The stress and circumstances of our situation eventually lead me to accept that if I desired for Amos to receive breastmilk, it would be through me pumping it. I am proud to have been able to give Amos breastmilk but even after he was home, I felt the strain of the time commitment exclusively pumping requires. I was less present and involved in Amos's early life than I would’ve liked.
Irrespective of my unique experience, motherhood blind sighted me; I wasn’t prepared for the identity shift. | I’ll never know how much my high-risk pregnancy influenced that but it significantly affected my postpartum adjustment. The demands of the last 11 weeks of my pregnancy shifted my focus off of the personal growth and work I had been doing as a mother already and sent my parasympathetic nervous system into survival mode. For more than a year I felt like I was playing catch up in all regards. The reality of having Amos felt so overwhelmingly contrasted against what I thought becoming a parent would be like during that time.
I work with a licensed professional counselor to effectively process what I have experienced and to have another support person in my postpartum corner. I’ve been a supporter/believer of mental health awareness/care for years, but my pregnancy, birth, and postpartum gave me a new perspective on the matter. Amos was four months old before I made my mental health a priority again. I sought out a practice that addresses my specific circumstance, chose a provider who’s skills and style matches my needs, pay for sessions out of pocket, and meet with my counselor during my work lunch break. I’m learning, growing, and healing. It’s challenging and uncomfortable, yes, but it also provides me with perspective, unbiased support for emotional/psychological processing, and a deeper self-awareness. I'm learning not only who I am on the other side of this experience but also how to be this me.
What is your truth?
Our stories and the emotional meaning we place on them are the most authentic truths we have.
I am capable. I am not alone. I am grateful. I was meant to be Amos's mother. The experience of his pregnancy, birth, and postpartum cannot be separated from who he is. To have him is to have the experience as it was/is. | I’m not the same person as I was before I became a mother. Motherhood is refining and redefining me.
Take care of your self: mentally, psychologically, emotionally, physically. Figure out what it means to give yourself grace, and then continue to give it to yourself through each new phase.
Why did you choose to participate in this movement and share your story?
I’m participating in the 4th Trimester Bodies Project as a way to continue owning and appreciating my story. I want to be honest about my motherhood. People asked frequently after Amos was born, “How’s Amos?” That question should've been preceded by or followed with “How are you?” every. single. time. There isn’t nearly enough attention given to postpartum and parenthood. 4th Trimester Bodies Project is changing that and I’m grateful to be a part of the change.